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Psych Nerdery: Cool Facts Edition

Random stuff about mental health I’m hoping you haven’t heard before! Relevant citations and further reading are located in the links on each number.

1. You can’t be diagnosed with a personality disorder until you are 18 years of age. [use drop-down menu at link]

2. Capgras delusion: believing that a family member or friend has been replaced with an imposter. The delusion provides a fascinating inside view into ways in which our memory functions.

3. Children who will go on to develop schizophrenia are found to have specific cognitive deficits by ages 6-7. (In developmental psychopathology classes, I was told that children who developed schizophrenia were shown to have slower affect–expression of emotion, in non-psych lingo–when observers looked at home movies of said children, even at ages as young as four. However, I can’t find a citation on this, and no longer have the textbook, so add a grain of salt.)

4. Hallucinations don’t just come as things you see–there’s also auditory hallucinations, tactile hallucinations (commonly manifests as feeling things crawling on you) and olfactory hallucinations (which can be pleasant or nasty smells).

5. Because the psych profession just likes confusing you, there’s both Obsessive Compulsive Disorder and Obsessive Compulsive Personality Disorder. They’re not very similar at all.

6. People with one personality disorder often meet criteria for diagnosis with another personality disorder. This is one of many problems with the PD diagnoses–how can one have multiple personality disorders (Obvious multiple personality jokes are obvious). It may be that some of the problem is that people aren’t exactly likely to come in for treatment of a PD–how often to people describe their own personality as flawed?

7. And speaking of multiple personalities, even though Dissociative Identity Disorder (which used to be called Multiple Personality Disorder) remains in the DSM, there’s lots and lots of evidence that it’s mainly a cultural phenomenon, and not an actual disorder. [The attached link is easy to read and in depth–I recommend it]

8. In fact, Sybil, the case that spawned media interest in DID/MPD…was maybe a fraud created by an unethical psychiatrist and her poor client?

9. Marsha Linehan created Dialectal Behavioral Therapy (DBT) originally for work on those with Borderline Personality Disorder–though it’s now been shown to be effective for substance abuse, mood disorders, sexual trauma, and self-harm. It’s was groundbreaking treatment for clients who are often considered untreatable. In 2011, during a speech, Linehan told the world that she had suffered from BPD for her entire life, and developed the treatment around her own quest to survive. So basically, she’s my hero.

10. Asking someone if they are feeling suicidal will not put the idea in their head–really, don’t be afraid to ask.

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10 thoughts on “Psych Nerdery: Cool Facts Edition”

Interesting post. On point number 1, I believe that only applies to certain personality disorders, such as antisocial personality disorder. Now I read it’s not advisable to diagnose a personality disorder before age 18 in most cases, but sometimes it can be warranted. Case in point, me. When I was 14, I became psychotic and started acting upon my delusions in bizarre and dangerous ways, resulting in my hospitalization. At first, they thought I had psychotic depression, but then they changed it to schizotypal personality disorder. Years later, I asked my psychiatrist about that, especially since I also had an Asperger’s syndrome diagnosis at the time, and he said that in his view I had come close to the borderline of schizophrenia. He mentioned, in addition to the psychosis, the presence of tangential speech and inappropriate affect. Of course, in light of my recently being diagnosed with bipolar disorder NOS, it’s not clear what I had. They thought the psychosis had lasted only a week or so–and the fact I was very unwilling to talk (because I didn’t want to be seen as crazy) didn’t help–but I years later told my psyche that I held the delusions for the better part of a two month period. So who knows what happened there. He says, though, that I don’t really exhibit schizotypal personality disorder anymore. So +1 for waiting till you’re 18 to diagnose a personality disorder.

Actually, histrionic and narcissistic PD’s are comorbid with other PD’s at higher rates than ASPD. ASPD is comorbid with Axis I disorders at a very high rate, (Axis I being things like mood disorders, anxiety, etc) which may be where you’re thinking about comorbidity.

“All pre-schizophrenic children were identified at above-chance levels, and the viewers noted less responsiveness, eye contact, and positive expression, and poorer fine and gross motor coordination as identifying characteristics.”

Not that I want to defend the science or ethics of the way psych has dealt with DID/MPD (at all, yuck) but multiplicity is really a thing that exists. It just doesn’t always (or ever?) work the way it was supposed to in the age of hype and hypnosis. I’ve been around in Rob’s head at least since we were four, with my own wants and feelings and my own thoughts and my own sexual orientation and my own dislike for mirrors because they’ve got the wrong face in them.

An old relative of mine has a peculiar “version” of Capgra’s. She thinks she is living in a replica of her Real Home. She recognizes that every detail there is exactly as they should be, but she just KNOWS it is not the Real Home.

I remember once hearing a radio show about people with schizophrenia making recordings of what their auditory hallucinations sounded like. Many of the people who participated would not, or could not, repeat the things the voices said to them because it was just too painful, traumatic, or private for them. So they approximated, but it was still absolutely chilling. When I heard that sample I think it was the moment that I realized what an absolutely terrifying experience that would be, and that it would be something that could drive even the best emotionally equipped person with the best resources to bizarre behavior or even suicide. It was terrifying to think your brain could just turn on you like that, and maybe more terrifying to think of how many people must suffer this torment.

Seems so stupid now, but it was harder (at least for me) to imagine that an auditory hallucination is not going to sound like it’s coming from your brain any more than a visual one would look like it was. I’m sure that’s part of the reason you included it, and I’m sure I’m not the only person who had trouble grasping it, sadly.